Kengo Hattori1, Shigeru Takamizawa2, Yuichiro Miyake2, Tomoko Hatata2, Katsumi Yoshizawa2, Tomoko Furukawa3, Yoshiaki Kondo3. 1. Department of Surgery, Nagano Children's Hospital, 3100 Toyoshina, Azumino City, Nagano, 399-8288, Japan. ken5hattori@gmail.com. 2. Department of Surgery, Nagano Children's Hospital, 3100 Toyoshina, Azumino City, Nagano, 399-8288, Japan. 3. Department of Radiology, Nagano Children's Hospital, Nagano, Japan.
Abstract
BACKGROUND: Sonographic assessment before congenital diaphragmatic hernia repair has rarely been studied. OBJECTIVE: To evaluate the accuracy of preoperative ultrasound in measuring the defect size and in anticipating the presence of a rim and thereby to determine ultrasound's usefulness in informing the surgical approach for definitive repair of congenital diaphragmatic hernia. MATERIALS AND METHODS: We performed a retrospective review of the medical records of seven children with left congenital diaphragmatic hernia who had undergone ultrasound and definitive repair between 2014 and 2017 at our institution. RESULTS: The estimated defect size by ultrasound to the actual defect size measured intraoperatively for each case were as follows: 23 × 25 mm to 20 × 26 mm (case 1); 23 × 30 mm to 20 × 30 mm (case 2); 43 × 25 mm to 30 × 30 mm (case 3); 21 × 23 mm to 20 × 25 mm (case 4); 19 × 24 mm to 10 × 30 mm (case 5); 32 × 33 mm to 30 × 50 mm (case 6); and almost total absence to 40 × 50 mm (case 7). Presence or absence of each part of the diaphragm rim evaluated by ultrasound was almost identical with the actual intraoperative findings. According to the ultrasound findings, we performed a successful thoracoscopic repair in cases 1-5 with relatively small defects and presence of all parts of the rim or absence of only posterolateral rim. CONCLUSION: There was good concordance between ultrasound findings and operative findings regarding the size of the defect and presence or absence of the diaphragm rim.
BACKGROUND: Sonographic assessment before congenital diaphragmatic hernia repair has rarely been studied. OBJECTIVE: To evaluate the accuracy of preoperative ultrasound in measuring the defect size and in anticipating the presence of a rim and thereby to determine ultrasound's usefulness in informing the surgical approach for definitive repair of congenital diaphragmatic hernia. MATERIALS AND METHODS: We performed a retrospective review of the medical records of seven children with left congenital diaphragmatic hernia who had undergone ultrasound and definitive repair between 2014 and 2017 at our institution. RESULTS: The estimated defect size by ultrasound to the actual defect size measured intraoperatively for each case were as follows: 23 × 25 mm to 20 × 26 mm (case 1); 23 × 30 mm to 20 × 30 mm (case 2); 43 × 25 mm to 30 × 30 mm (case 3); 21 × 23 mm to 20 × 25 mm (case 4); 19 × 24 mm to 10 × 30 mm (case 5); 32 × 33 mm to 30 × 50 mm (case 6); and almost total absence to 40 × 50 mm (case 7). Presence or absence of each part of the diaphragm rim evaluated by ultrasound was almost identical with the actual intraoperative findings. According to the ultrasound findings, we performed a successful thoracoscopic repair in cases 1-5 with relatively small defects and presence of all parts of the rim or absence of only posterolateral rim. CONCLUSION: There was good concordance between ultrasound findings and operative findings regarding the size of the defect and presence or absence of the diaphragm rim.
Authors: Stylianos D Megremis; Nikolaos I Segkos; Georgios P Gavridakis; Michael G Mattheakis; Elias G Kehayas; Lambros B Triantafyllou; Evaggelia E Sfakianaki; Georgios E Chalkiadakis Journal: J Clin Ultrasound Date: 2005-10 Impact factor: 0.910
Authors: Sophie Costerus; Katrin Zahn; Kees van de Ven; John Vlot; Lucas Wessel; Rene Wijnen Journal: Surg Endosc Date: 2015-10-21 Impact factor: 4.584
Authors: Boaz Karmazyn; Andrew J Shold; Lisa R Delaney; Brandon P Brown; Megan B Marine; S Gregory Jennings; Brian W Gray Journal: Pediatr Radiol Date: 2019-05-28